ColonoscopyColonoscopy is the examination of the large colon and part of the small colon with a fiber optic camera on a flexible tube passed through the anus. Prior to the colonoscopy the patient is given laxatives so that the bowels are relatively clean for the examination. During the procedure the patient is often sedated intravenously. Colonoscopies are most often used to diagnose or rule out colon cancer, but are also frequently used to diagnose inflammatory bowel disease.
Colonoscopy (koh-luh-NAH-skuh-pee) lets the physician look inside your entire large intestine, from the lowest part, the rectum, all the way up through the colon to the lower end of the small intestine. The procedure is used to look for early signs of cancer in the colon and rectum. It is also used to diagnose the causes of unexplained changes in bowel habits. Colonoscopy enables the physician to see inflamed tissue, abnormal growths, ulcers, and bleeding. For the procedure, you will lie on your left side on the examining table. You will probably be given a narcotic pain medication (such as Demerol) and a mild sedative to keep you comfortable and to help you relax during the exam. You may enter a so-called "twilight" state, where you are comfortably between sleep and wakefulness. The drugs are not strictly necessary, but most people find the procedure uncomfortable and boring without the sedation. The physician will insert a long, flexible, lighted tube into your rectum and slowly guide it into your colon. The tube is called a colonoscope (koh-LON-oh-skope). The scope transmits an image of the inside of the colon, so the physician can carefully examine the lining of the colon. The scope bends, so the physician can move it around the curves of your colon. You may be asked to change position occasionally to help the physician move the scope. The scope also blows air into your colon, which inflates the colon and helps the physician see better. If anything abnormal is seen in your colon, like a polyp or inflamed tissue, the physician can remove all or part of it using tiny instruments passed through the scope. That tissue (biopsy) is then sent to a lab for testing. If there is bleeding in the colon, the physician can pass a laser, heater probe, or electrical probe, or inject special medicines through the scope and use it to stop the bleeding. Bleeding and puncture of the colon are possible complications of colonoscopy. However, such complications are uncommon. Colonoscopy takes 30 to 60 minutes. The sedative and pain medicine should keep you from feeling much discomfort during the exam. You will need to remain at the endoscopy facility for 1 to 2 hours until the sedative wears off. One common and somewhat amusing side-effect is that you may fart afterwards, to release all the air that has been blown into your bowel.
Your colon must be completely empty for the colonoscopy to be thorough and safe. To prepare for the procedure you may have to follow a liquid diet for 1 to 3 days beforehand. A liquid diet means fat-free bouillon or broth, strained fruit juice, water, plain coffee, plain tea, or diet soda. Gelatin or popsicles in any color but red may also be eaten. You will also take one of several types of laxatives the night before the procedure. Also, you must arrange for someone to take you home afterward--you will not be allowed to drive because of the sedatives. Your physician may give you other special instructions. Inform your physician of any medical conditions or medications that you take before the colonscopy.
This article contains material originally derived from the public domain NIH Publication No. 02-4331, dated February 2002, URL http://digestive.niddk.nih.gov/ddiseases/pubs/colonoscopy/ Please update as needed.
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